EDITORIALS
Recent advances in exacerbations of COPD
1 Department of Clinical Medical Sciences, University of West Indies, Mount Hope, Trinidad and Tobago
2 Department of Respiratory Medicine, National Heart and Lung Institute, MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, Imperial College London, London, UK
Correspondence to:
Dr Terence Seemungal, Department of Clinical Medical Sciences, University of the West Indies, St Augustine Campus, Trinidad and Tobago; tseemungal@aol.com
| The first 150 words of the full text of this article appear below. |
The First International Conference on Exacerbations of Airways Disease (ICEAD) brought together experts from both sides of the Atlantic to discuss problems in the management of exacerbations of both asthma and chronic obstructive pulmonary disease (COPD). A brief overview of these discussions on COPD exacerbations follows.
Up to 18 definitions of a COPD exacerbation have been advanced, from less explicit1 to very explicit symptom based criteria.2 3 However, large therapeutic trials in COPD have all used treatment based definitions.4 5 The first consensus definition was treatment based but the current GOLD guidelines accept a symptom based definition.6 7 Biochemical or physiological markers applied in studies using either definition8 9 have all shown significant changes, supporting the validity of these approaches to a definition but lack specificity and sensitivity. The healthcare utilisation approach to severity of exacerbation may be more robust as it has been related to mortality10 but does not allow for detection of
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